视神经脊髓炎谱系疾病复发相关因素的临床研究

Clinical study the relapse correlation factors of Neuromyelitis Optica Spectrum Disorders

目的研究视神经脊髓炎谱系疾病（NMOSD）的复发率及其临床特征,分析多因素与NMOSD复发的相关性。方法分析2009年7月29日~2015年12月31日就诊于本院神经内科确诊73例NMOSD患者的临床、实验室检查及扩展残疾状态量表（EDSS）评分等资料。运用卡方检验、Logistic回归分析等统计学方法分析影响NMOSD复发的危险因素。结果 73例NMSOD患者中,男性12例,女性61例,男女比例约1∶5,首次发病中位年龄38岁。血清水通道蛋白-4抗体（AQP4-Ab）阳性检出率84.9%（62/73）,血清其他自身免疫抗体阳性72.6%（53/73）,脑脊液（CSF）AQP4-Ab阳性检出率45.1%（23/51）,CSF蛋白升高率43.9%（25/57）。有序Logistic回归分析结果显示血清AQP4-Ab（OR=14.556〉1,95%CI 0.120~2.809）、自身免疫抗体（OR=4.328〉1,95%CI 0.684~4.673）阳性可能是NMOSD发病3 y内复发的独立危险因素。结论血清AQP4-Ab及其他自身免疫抗体阳性可能与NMOSD发病3 y内复发频次呈正相关。

Objective To analysis the general clinical characteristics and recurrence of neuromyelitis optica spectrum disorders（ NMOSD） in the 3 years,and to investigate the correlations between several recurrent-related of NMOSD.Methods The clinical data of 73 cases who visited the Department of Neurology at our hospital from July 29 th 2009 to December 31 th 2015 were analyzed retrospectively,including clinical material,laboratory statistics and the expanded disability status scale（ EDSS） scores. Using the chi-square test and Logistic regression analysis and the other statistical methods to analysis the relapse correlation factors of NMOSD. Results Patients included 12 males,61 females. Male to female ratio was 1 to 5 among the patients. The median onset age of NMOSD was 38 years old. Serum AQP4-Ab positive rate was84. 9%（ 62 /73）,cerebrospinal fluid（ CSF） positive rate was 45. 1%（ 23 /51） and autoimmune antibodies positive rate72. 6%（ 53 /73） in the study. The CSF protein was increased 43. 9%（ 25 /57）. Serum AQP4-Ab positive（ OR =14. 556 1,95% CI 0. 120 ~ 2. 809） and other autoimmune antibodies positive（ OR = 4. 328 1,95% CI 0. 684 ~ 4. 673）is independent risk factors for affecting the incidence of NMOSD 3 years recurrence times proved by ordinal logistic regression analysis. Conclusions There is a positive correlation between serum AQP4-Ab positive,other autoimmune antibody positive and the incidence of NMOSD 3 years recurrence times.